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Nutritional support for the patient with diabetes

D M Pitts, K A Kilo, S L Pontious

    Critical Care Nursing Clinics of North America
    |March 1, 1993
    PubMed
    Summary

    Successful nutritional support for critically ill patients with diabetes mellitus requires meeting metabolic needs and maintaining blood glucose between 100-200 mg/dL. Optimal insulin dosing and preventing complications are crucial for effective treatment.

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    Area of Science:

    • Critical Care Medicine
    • Endocrinology
    • Nutritional Science

    Background:

    • Critically ill patients with diabetes mellitus present unique challenges for nutritional support.
    • Maintaining glycemic control is essential but complex in this patient population.

    Purpose of the Study:

    • To outline the key components for successful nutritional support in critically ill patients with diabetes mellitus.
    • To emphasize the importance of integrated glycemic control and nutritional management.

    Main Methods:

    • Review of current best practices in nutritional and glycemic management for critically ill diabetic patients.
    • Analysis of factors influencing insulin dosage and nutritional requirements.
    • Emphasis on continuous monitoring and assessment.

    Main Results:

    • Successful nutritional support hinges on meeting metabolic demands and maintaining blood glucose levels between 100 and 200 mg/dL.
    • Prevention of hyperglycemia, sepsis, and hypoglycemia is critical.
    • Insulin dosages must account for metabolic needs, stress, pharmacologic therapy, and illness severity.

    Conclusions:

    • Integrated glycemic control and appropriate insulin administration are paramount for effective nutritional support.
    • Careful monitoring of blood glucose, chemistries, and physical assessment are essential.
    • Further research is needed to define optimal glycemic control targets for this population.

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